Watch Out For Symptoms of Diabetic Eye Disease

Get Comprehensive Diabetes Eye Exam

The most important thing to take away from this article is the need for a comprehensive eye exam every year. This is the best way to detect and treat issues before they cause irreversible damage.

According to The National Eye Institute, a comprehensive dilated eye exam will check for the following:

Changes to blood vessels

Leaking blood vessels or warning signs of leaky blood vessels

Swelling of the macula (DME)

Changes in the lens

Damage to nerve tissue

The following are the different types of eye diseases or conditions that can develop and more information on each.

Diabetic Retinopathy

The retina is very sensitive to light and located at the back of the eye. According to the NIH’s National Eye Institute, the blood vessels in this area are vulnerable to damage from high blood sugar levels. These tiny blood vessels can leak blood and other fluids then the retinal tissue swells resulting in cloudy or blurred vision.

This is the most common cause of vision loss in people with diabetes and it is the most common cause of vision loss and blindness in working-age adults.

There are often no visual symptoms of diabetic retinopathy until it has progressed past the early stages. This is why the American Diabetes Association, American Optometric Association and others recommend that people with diabetes get a comprehensive dilated eye exam at least once a year. This is because detection and treatment of a problem early on means vision loss and disease progression can be halted or slowed and then properly tracked.

Types of Diabetic Retinopathy

There are two classifications of diabetic retinopathy according to the AOA:

Non-proliferative diabetic retinopathy (NPDR) is the early stage of the disease in which symptoms will be mild or nonexistent. In NPDR, the blood vessels in the retina are weakened. Tiny bulges in the blood vessels, called microaneurysms, may leak fluid into the retina. This leakage may lead to swelling of the macula.

Proliferative diabetic retinopathy (PDR) is the advanced form of the disease. At this point, circulation problems deprive the retina of oxygen. Then fragile blood vessels begin to grow in the retina and vitreous (the gel-like fluid in the back of the eye). The new blood vessels may leak blood into the vitreous, clouding vision.

Stages of Eye Disease

Mild nonproliferative retinopathy. Small areas of balloon-like swelling in the retina’s tiny blood vessels, called microaneurysms, occur at this earliest stage of the disease. These microaneurysms may leak fluid into the retina.

Moderate nonproliferative retinopathy. As the disease progresses, blood vessels that nourish the retina may swell and distort. They may also lose their ability to transport blood. Both conditions cause characteristic changes to the appearance of the retina and may contribute to DME.

Severe nonproliferative retinopathy. Many more blood vessels are blocked, depriving blood supply to areas of the retina. These areas secrete growth factors that signal the retina to grow new blood vessels.

Proliferative diabetic retinopathy (PDR). At this advanced stage, growth factors secreted by the retina trigger the proliferation of new blood vessels, which grow along the inside surface of the retina and into the vitreous gel (the gel-like fluid in the eye). The new blood vessels are fragile and this causes them to bleed easily. Accompanying scar tissue can contract and cause retinal detachment—the pulling away of the retina from underlying tissue.

The American Optometric Association states that treatment for diabetic retinopathy may include a quick laser surgery to stop leaking blood vessels or an injected medication to lower inflammation or to stop new blood vessels from forming.

In severe cases, surgery may be needed to replace the vitreous, or gel-like fluid in the back of the eye or to repair a retinal detachment.

Risk Factors for Diabetic Retinopathy

Diabetes: People with type 1 and type 2 diabetes are at a much higher risk for developing diabetic retinopathy, especially the longer they have diabetes. The risk for retinopathy goes up if blood sugar management is poor.

Race: Hispanics and African Americans are at greater risk for developing diabetic retinopathy.

Additional medical conditions: People with other medical conditions, such as high blood pressure have a higher risk of diabetic retinopathy.

Pregnancy: Pregnant women face a higher risk for developing diabetic retinopathy because of the extra stress on the body.

How to Slow Progression of Diabetic Retinopathy

Last but not least, manage blood sugars as well as possible to help prevent or slow further damage and don’t miss check-ups which can allow your doctor to keep close track of your condition and prescribe treatments on time. Diabetic Eye Disease is treatable, especially when caught early.

Diabetic Macular Edema (DME)

The National Eye Institute (NEI) states that macular edema results from diabetic retinopathy and means there is swelling in a part of the retina called the macula. This swelling is due to a build-up of fluid. “The macula is important for the sharp, straight-ahead vision that is used for reading, recognizing faces, and driving.”

DME is the main cause of vision loss in people with diabetic retinopathy and the NEI stages that approximately 50% of people with diabetic retinopathy end up developing DME which is more likely to happen as retinopathy progresses but can happen at any stage of retinopathy.

Cataracts

A cataract is a clouding of the lens in the eye. Adults with diabetes are about two to five times more likely than those without diabetes to have cataracts.

Glaucoma

Glaucoma involves damage to the optic nerve in the eye. The optic nerve is a bundle of nerve fibers which connects the eye to the brain. In adults with diabetes, having diabetes almost doubles the risk of glaucoma.

Treatments

When blood vessels are discovered to be leaking in the eyes in diabetic retinopathy, you may need a laser photocoagulation to prevent any further vision loss. This is a quick surgery that uses laser beams to scar certain parts of the retina in order to shrink blood vessels and stop new ones form forming or to stop the leaking which may cause swelling in the macula of the eye. The Joslin Center states that laser surgery and proper follow-up care may reduce your risk for blindness by 90 percent!

If hemorrhaging from blood vessels leaking in the eyes is present you may need a vitrectomy surgery to restore your vision. In a vitrectomy, a doctor would make an incision in the eye and remove vitreous gel which is clouded with blood and blocking vision. Then the vitreous gel is replaced with a salt solution which easily replaces the duty of the vitreous gel.

Treatments for retinopathy also include injected medications like steroids to help with the swelling, leaking, or development of blood vessels in the retina.

For people with cataracts, surgery is necessary once vision is greatly affected. A doctor would conduct a procedure to remove the cloudy lens and replace it with an artificial one.

In those with glaucoma, depending on the severity, a doctor may suggest medicated eye drops, laser surgery, or a number of other surgical procedures discussed in detail by the American Academy of Ophthalmalogy.